Individual
MR. GERARD ANTHONY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED, ATC, LAT
Contact information
Practice address
NICHOLLS STATE UNIVERSITY, 906 EAST FIRST STREET, THIBODAUX, LA 70310-0001
(985) 493-2612
(985) 493-2614
Mailing address
303 HERMITAGE DR, THIBODAUX, LA 70301-2916
(985) 448-2874
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J00108
LA
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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